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Cuts make mental health services ‘unsafe’ for use

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A new report into mental health services shows that cuts, shortages and short-term thinking is only making them worse, writes Simon Basketter
Issue 2376

Mental health crisis services in England are “unsafe” and are delivering substandard care to acutely unwell adults and children.

An investigation by Community Care and the BBC found the NHS has shut more than 1,700 beds in two years.

This represents a 9 percent reduction in the total number of mental health beds—18,924—available in 2011/12.

Three quarters of the bed closures were in acute adult wards, older people’s wards and psychiatric intensive care units.

Northumberland, Tyne and Wear NHS Trust has cut its inpatient beds by 157, while St George’s and South West London has removed 155 beds.

The result is that adult psychiatric wards are running occupancy levels of more than 100 percent. 

This means some patients are being sent to private hospitals many miles from home or admitted to NHS hospitals without a bed.

One patient took her own life two days after professionals tried to admit her to an NHS unit only to be told there were no beds available.

Mandy Peck told psychiatric staff she was feeling suicidal but her local mental health service centre said they had no beds available. 

A day later she jumped to her death from a multi-storey car park. A subsequent investigation found that a bed had actually been available.

The report found that:

  • Children and young people are being admitted to adult psychiatric wards due to a nationwide shortage of specialist children’s beds.
  • Patients admitted to wards are “increasingly seriously ill” placing an extra strain on ward staff.
  • Pressures to free-up beds are leading to patients being discharged too early, social workers warn. 

At one trust such pressures meant that one patient was admitted eight times in 12 months.

Three quarters of bed cuts—1,291 closures—were made on admission wards and psychiatric intensive care units for acutely unwell adults and older people.

The NHS’s remaining inpatient units are overstretched. 

Ward occupancy data obtained from half of England’s mental health trusts found adult admission wards averaged an occupancy level of 101 percent on 1 August this year.

The Royal College of Psychiatrists recommends occupancy levels of 85 percent. Yet individual wards were running at up to 138 percent.

Wards usually manage the excess people in need of help by filling beds temporarily freed up when patients are sent home on short-term leave.

One social worker warned that this is risky as patients who relapse “are not able to return to the ward if they need to”.

One trust’s complaint log revealed an incident where a patient “on weekend leave was refused re-entry back into the ward on the Saturday even though he was in crisis. 

The ward informed [the patient’s] carer that his bed had been allocated to another patient and that there was no room for him.”

Policing people who are ill

Lucy Bowden ended up in the back of a police van due to a lack of beds after voluntarily seeking help. 

The 33 year old, who has a history of self-harming, was left to wander around the grounds of her local accident and emergency hospital. 

She was told there were no psychiatric beds available. Eventually the police were called. 

“They couldn’t find anywhere so they were saying I’d have to go in to police custody, in a police station which would mean I’d have to go into a cell. 

“Eventually they found a bed and I had to go into the back of a police van, in the cage in the back. It was horrible,” she said.

Vulnerable victims are dismissed or disbelieved

People with mental illnesses are three times more likely to be victims of crime than the general population.

Victims say that their reports to the police were often dismissed or disbelieved.

According to a study from Victim Support and Mind almost half of people with some form of mental illness had experienced a crime in the last year. 

It said people with severe mental illness were five times more likely to experience assault.

Severely mentally ill women were ten times more likely to be assaulted. 

Six out of ten women in this group reported being victims of sexual violence, the study said.

Help for young people is slashed

Some 34 out of 51 councils have slashed spending on children and adolescent mental health services according to a recent survey by the charity Young Minds.

Derby City Council reported cuts of 41 percent compared to 35 percent in Norfolk. 

In the North East the figure was 27 percent.

More calls due to money fears

More people are calling mental health helplines and more are contemplating killing themselves than in previous years.

Mind, the mental health charity, said 30 percent more callers were considering killing themselves in 2012/13 compared to 2011/2012.

Many said they had severe financial worries.

Profiting out of poor health

Manchester Health and Social Care Trust has spent £1.75 million on out-of-area private beds in four months. 

This means private firms are hoovering up NHS cash rather than care being provided by the NHS.

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